Final Rule on Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023

Published: 09/26/2024

Sources:
  • Centers for Medicare and Medicaid Services
Relevant To:
  • Critical Access Hospitals,
  • Home Health,
  • Hospitals,
  • Long Term Care,
  • Ambulatory Care,
  • Inpatient Rehabilitation Facility,
  • Hospice

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule entitled, “Medicare Program: Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023” (CMS-1799-F). This final rule is part of a larger strategy to address significant, anomalous, and highly suspect (SAHS) billing activity within Accountable Care Organizations (ACOs) reconciliation. Calendar year (CY) 2025 Physicia

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